Related Experiment Video
Updated: Jun 14, 2025
Author Spotlight: Advancing Hepatobiliary and Pancreatic Tumor Treatment with Minimally Invasive Surgical Techniques
Published on: September 27, 2024
Surgical risk calculator development for postoperative outcomes after laparoscopic cholecystectomy: a multicenter
Huisong Lee1, In Woong Han2, Ji Eun Choi3
1Department of Surgery, Ewha Womans University College of Medicine, Seoul, Korea.
Purpose:
Laparoscopic cholecystectomy is the standard surgical procedure for benign gallbladder disease. However, the analysis of risk factors for complications, including serious complications such as bile duct injury (BDI), has been largely overlooked. This study aimed to collect standardized prospective data from multiple centers and to develop a predictive model for laparoscopic cholecystectomy complications.
Methods:
This study included 2,514 patients who underwent laparoscopic cholecystectomy for benign gallbladder disease at 18 academic institutes in Korea. Fifty-six preoperative and intraoperative variables were analyzed as risk factors for adverse postoperative outcomes, including overall complications. A surgical risk calculator was developed using a multivariate logistic regression analysis.
Results:
Of the 2,514 patients, 62 (2.5%) experienced surgery-related complications, including BDI in 17 (0.7%). Various factors such as sex, age, smoking, emergency operation, hypertension, diabetes mellitus, chronic obstructive pulmonary disease, preoperative endoscopic common bile duct stone removal, therapeutic antibiotics usage, American Society of Anesthesiologists physical status classification, and acute cholecystitis were found to be associated with postoperative adverse outcomes. Based on these variables, a surgical risk calculator was developed for overall complications, systemic complications, surgery-related complications, BDI, and delayed discharge, with the area under the curve values of 0.733, 0.775, 0.697, 0.857, and 0.833, respectively.
Conclusion:
This study developed a surgical risk calculator using standardized variables from a multi-institutional prospective database to predict adverse outcomes after laparoscopic cholecystectomy. This tool can be used for risk stratification prior to cholecystectomy.
